The late Nora Ephron may have been the first to declare publicly how bad she felt about her neck, but women everywhere understand the feeling. In fact, some of those who are most troubled by the dreaded turkey wattle are not yet at the midcentury mark—significantly younger than Ephron was when she penned her treatise. And these women are not donning turtlenecks and scarves à la Ephron: They're taking action, opting for high-tech neck-lifts with fast results.

A long, smooth, elegant neck has always been a coveted feature. "Consider some of the all-time great beauties—Audrey Hepburn, Elizabeth Taylor," says Sam Rizk, a New York plastic surgeon who specializes in face and neck work. "That crisp and clean neckline is the gold standard of youth." The neck ages similarly to the face; in the late 30s and early 40s, fine lines appear, texture becomes uneven or splotchy, and in the 40s, gravity kicks in, resulting in slackness and sag, explains Adam Kolker, a plastic surgeon in New York known for his natural-looking results.

Many top doctors have noticed that younger women are turning more and more to neck-lifts as a stand-alone procedure. "In the past five years, I've seen a 50 percent increase in patients between 39 and 50 asking for neck work," says Rizk. Some are having a platysmaplasty, a procedure in which the ropy, sagging muscles that can give an aged appearance are knitted back together (much like a corset nips in the waist) through a small incision under the chin. Others are choosing the more traditional lift, which requires incisions around the ears, excising loose skin and sewing what remains into an elevated position.

So what's behind the sudden spike? In a sense, fillers and neurotoxins like Botox are largely the reason, suggests Rizk. Women are availing themselves, early and judiciously, of the latest injectables as well as having peels and laser treatments. Consequently, you have 40-something women whose faces are barely pushing 30—taut, lineless, and plump—but should you gaze farther south and see spotty, saggy skin or a jowly jawline, it's a dead giveaway. Botox, liposuction, Ultherapy, and Thermage can help, Rizk says, but neck-lift surgery offers the most dramatic tightening. Kelly*, 44, boasts that her face doesn't look a day over 30 (thanks to careful needlework) but says that her neck "had this sag to it that made me look older than I am." After her neck-lift, "no one could put their finger on it. They all said, 'You look so well rested.'"

While the basic neck-lift hasn't changed in decades, what's new are the surgical techniques that greatly reduce scarring and recovery time. Rizk pioneered a method using a high-definition telescopic device that enables him to make smaller incisions and better see the neck tissue. Securing the incisions with tissue glue eliminates the need for drains, speeding healing and recovery—usually 10 to 12 days—though Rizk claims that his patients are often in "socially presentable shape" in half that time. Surgeon's fees range from $8,500 to $15,000; results typically last eight to 10 years.

Of course, not all doctors agree about the supremacy of the scalpel. New York dermatologist Bruce Katz likes the Alma ClearLift laser: "It bypasses the outer layer of skin, where it boosts collagen growth and lifts sagging skin. There's zero pain or redness." Cost: $300 to $500 per treatment; three to five are recommended. Still, for the longest-lasting results, experts like Kolker maintain that you'll eventually graduate to surgery. "The real truth is, to correct the effects of gravity, you need to resuspend the muscle and skin," he says. The luminous, antiaging result for the woman whose neck now matches her face is undeniable, adds Katz. "It's like going from a 40-watt lightbulb to a 100-watt bulb."